Month: March 2017

About a week or so ago I was talking to some girlfriends about work. The subject came up about how long I would work and if medicine would be my only career. It got me thinking about what I might do when they stop letting me show up at the hospital every day. The short version is, I’d make spaghetti.

It’s March. In Oklahoma that means we are getting our first look at severe weather warnings, hours and hours of live shot cloud formations and lightning strikes and reports on damage from such severe weather. Unfortunately, Oklahomans are all too familiar with the aftermath of tornadoes and other severe weather events. Damage, destruction, deaths, devastation. But that’s not all that comes in the aftermath. What also arrives are people and organizations. People and organizations who bring trucks and tools and supplies and food and hands and grace and love. One of the most recognized organizations in disaster response is the American Red Cross.

And that’s where the spaghetti comes in. For as long as I can remember I enjoyed making food in large quantities. I’d get out a big pot or pan and chop and stir and boil and whatever until a great big amount of something was made. It’s problematic when you are a household of 2. So in the first years of our marriage our condo would be full of hungry college students or hungry medical students who would eat and eat and then take food home. Over the years I have learned to taper down and not make enough food to feed the neighborhood. March is Red Cross month. Buildings across the US will be lit up with red lights to honor the 300,000 volunteers who respond to over 60,000 disasters and bring with them life saving food and water. The Red Cross supplies about 40% of the nation’s blood supply. And almost everyone who serves with the Red Cross is a volunteer. Can you believe that?

I can remember being a kid and seeing news coverage of tornado damage in my state. And I remember the trucks. The trucks with a big red cross on the side. And in my mind I would imagine all the volunteers unloading those big pots and pans and making big pots of spaghetti or soup and sandwiches and all I wanted to do was go and stir something with a giant spoon.

Let’s take a moment to honor and support the thousands and thousands and thousands of people who make the American Red Cross go. Maybe they love making giant quantities of food. Maybe they feel a call to make a tangible difference when people are at their most vulnerable point of need. Whatever it is, they have chosen to serve in a disastrous time. So donate blood. Give money. Volunteer. Take a class to learn how to help. Do something now. Don’t wait for a second career.

What will I do when I stop being a gynecologist? I hope whatever it is the Pastor and I are doing we will be serving people in need. And that just might mean climbing out of a big truck and stirring a pot of spaghetti.

Last Wednesday I was home from being on call and watching ESPN. The popular show “First Take” was on and they showed two videos of NFL players in what I will describe as “compromising” circumstances with women. What followed was commentary that included phrases such as “two consenting adults” and “clearly she is giving consent.” During the 15 minute debate on who was behaving worse than whom and if the two situations were different I was feeling the heat rise up around my neck and feverishly beginning this blog post. In short, that’s not how consent works. That’s not how any of this works.

If you follow this blog you know I have written about sexual assault. Lots of assumptions are made when non-consensual contact occurs. Lots of victim blaming. Often times the focus is on what she wore, how much she drank, what she “implied.” The truth is it doesn’t matter what someone wears or what they drink or how they act. Consent isn’t implied. Consent is either given or not given. And more importantly consent can be revoked at any time.

As physicians we gain consent on a daily basis. Sometimes it’s as simple as saying “I am going to listen to your heart and lungs now, if that’s ok.” Other times we are making a decision to perform a surgery. In that case we have a long discussion about the risks, the benefits, the non-surgical options. And more importantly, we confirm that the patient understands what is happening to their body and confirm before we start that surgery that the patient still wants to have the procedure. Even in the case of emergencies we do all we can to make sure our patients or their families understand what is happening. We do all this because consent matters.

So what would I say to the hosts of ESPN’s First Take. To Stephen A. Smith, Molly Qerim and Max Kellerman. While we can debate the professionalism of the behavior of these professional athletes and if their past behavior, their race or their status in life makes a difference in how their actions are seen or judged, we cannot make assumptions about whether or not either of the women involved gave consent. Just because someone doesn’t seem upset or angry doesn’t mean they have given consent. So let’s stop making statements that imply that we can look at someone and know whether or not they are giving consent. Instead can we make sure we are sending a message that consent is important and as adults we should make sure we understand that. How about the people at First Take try a second take on this one.

Talking to patients about disease prevention and improving their health isn’t always easy. It’s like when your mom told you to eat your fruits and vegetables and you would roll your eyes…or was that just me? Every day doctors are faced with the challenge of not only caring for the patient’s immediate issues but reminding them to exercise, nudging them to lose weight and recommending appropriate screening tests. For me, I often get to recommend the ultimate trifecta: a mammogram, pap test and colonoscopy. Patients look at me like I have offered them a few hours locked in a small room with screaming children. Seriously.

March is colorectal cancer awareness month. Despite being a preventable disease, it is the second leading cause of cancer death in our country. Colon cancer screening is recommended for everyone age 50 and above. The polyps that become colon cancer usually don’t have symptoms which means you need a colonoscopy to find them and remove them. Some patients are at an increased risk of colorectal cancer above the rest of the population. Patients with inflammatory bowel diseases or a family history of colon cancer are at increased risk. About 5% of patients with colorectal cancer will have a genetic predisposition for the disease, such as Lynch syndrome, which is a genetic condition associated with an increased risk of colon, uterine and other cancers. Patients who are overweight or have poor diets may be at increased risk.

Therefore, your favorite gynecologist gets to recommend such tests and you get to roll your eyes at me. See the pattern here? In all seriousness, about 1/3 of adults who need colon cancer screening don’t get it. And I understand the eye rolling, I really do. It’s not like people look forward to having a colonoscopy. Or going to the gynecologist at that. I tell my patients that at least when I go to the dentist I feel like I’m a bright, cleaner person at the end of the visit. I’m not sure anyone leaves my office, or their mammogram or colonoscopy with the same thoughts. So I get it.

But here’s the deal. We don’t recommend these uncomfortable tests because we like seeing you squirm around on the exam table. We do it because cancer screening saves lives. March for myself and the pastor means lots of basketball and brackets and yelling at the tv. We love the madness. But when you think of march, think about reducing your risk of cancer. Know your family history. Eat your fruits and veggies and go to the gym. See your doctor. And get your colorectal cancer screening. It won’t be the best day of your life, but it just might be the day that saves it.

Sometimes I go to the grocery store and fool myself into thinking I don’t need a cart. I think “I only need like 4 things so I’ll just carry them.” And then I end up getting 12 things and now I’m the distressed lady with the arm full of things and one of them keeps dropping and when I go to pick it up another one falls out of my arms. But I can’t put anything down. Somehow I’ve convinced myself I need all of them. I finally make it to the cash register and swear I’ll never go cart-less again…until I do.

How many of us are experiencing life that resembles my grocery shopping? Your arms are full and you keep dropping things but you can’t seem to stop picking things up. Maybe it’s just me but my hands felt more than full these last few weeks. There is this illusion that you can find the perfect balance and nothing will fall, but in reality there is no way to arrange all the things you have accumulated in your hands that will hold them all.

Today I read a very compelling article by Jessica Hagy addressing work-life balance. It’s an illusion really. The notion that if you put things in just the right spot that you can achieve it. The reality is that there is no balance. Some days you just have to set something down. And only you can decide what you set down. All I ask is that you remember that everyone else is trying to set something down too. You see, what you choose to put down might not be what I choose to put down. And that’s ok.